TY - JOUR
T1 - Assessment of severity of aortic regurgitation using the width of the vena contracta
T2 - A clinical color Doppler imaging study
AU - Tribouilloy, Christophe M.
AU - Enriquez-Sarano, Maurice
AU - Bailey, Kent R.
AU - Seward, James B.
AU - Tajik, A. Jamil
PY - 2000/8/1
Y1 - 2000/8/1
N2 - Background - The width of the vena contracta (VC-W), the smallest area of regurgitant flow, reflects the degree of valvular regurgitation and is measurable by color Doppler imaging, but this method has not been validated in aortic regurgitation (AR). Methods and Results - We prospectively examined 79 patients with isolated AR and 80 patients without regurgitation. The VC-W was measured from the long-axis parasternal view and compared with 2 simultaneous reference methods (quantitative Doppler and 2D echocardiography). In patients without regurgitation, the agreement between methods was excellent. In patients with AR, good correlations (all P < 0.0001) were obtained between VC-W and effective regurgitant orifice (ERO) area and regurgitant volume recorded by quantitative Doppler (r = 0.89 and 0.90, respectively) and 2D echocardiographic (r=0.90 and 0.89, respectively) methods. These correlations were similar with eccentric or central jets (all P > 0.60). The other methods used showed good correlations of VC-W with aortographic grading of AR (n = 8, r = 0.82, P = 0.01), with the proximal flow convergence method (n = 53, r = 0.85, P < 0.0001), and with left ventricular end-diastolic volume (r = 0.81, P < 0.0001). Sensitivity and specificity of VC-W ≥6 mm for diagnosing severe AR (ERa ≥30 mm2) were 95% and 90%, respectively. Conclusions - For assessment of the degree of AR, VC-W shows good correlations with simultaneous quantitative measures (regardless of jet direction), shows good correlations with other methods of assessment of AR, and provides a high diagnostic value for severe AR. VC-W is a simple, reliable method that can be used clinically as part of comprehensive Doppler echocardiographic assessment of AR.
AB - Background - The width of the vena contracta (VC-W), the smallest area of regurgitant flow, reflects the degree of valvular regurgitation and is measurable by color Doppler imaging, but this method has not been validated in aortic regurgitation (AR). Methods and Results - We prospectively examined 79 patients with isolated AR and 80 patients without regurgitation. The VC-W was measured from the long-axis parasternal view and compared with 2 simultaneous reference methods (quantitative Doppler and 2D echocardiography). In patients without regurgitation, the agreement between methods was excellent. In patients with AR, good correlations (all P < 0.0001) were obtained between VC-W and effective regurgitant orifice (ERO) area and regurgitant volume recorded by quantitative Doppler (r = 0.89 and 0.90, respectively) and 2D echocardiographic (r=0.90 and 0.89, respectively) methods. These correlations were similar with eccentric or central jets (all P > 0.60). The other methods used showed good correlations of VC-W with aortographic grading of AR (n = 8, r = 0.82, P = 0.01), with the proximal flow convergence method (n = 53, r = 0.85, P < 0.0001), and with left ventricular end-diastolic volume (r = 0.81, P < 0.0001). Sensitivity and specificity of VC-W ≥6 mm for diagnosing severe AR (ERa ≥30 mm2) were 95% and 90%, respectively. Conclusions - For assessment of the degree of AR, VC-W shows good correlations with simultaneous quantitative measures (regardless of jet direction), shows good correlations with other methods of assessment of AR, and provides a high diagnostic value for severe AR. VC-W is a simple, reliable method that can be used clinically as part of comprehensive Doppler echocardiographic assessment of AR.
KW - Aorta
KW - Echocardiography
KW - Regurgitation
KW - Valves
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U2 - 10.1161/01.CIR.102.5.558
DO - 10.1161/01.CIR.102.5.558
M3 - Article
C2 - 10920069
AN - SCOPUS:0034255235
SN - 0009-7322
VL - 102
SP - 558
EP - 564
JO - Circulation
JF - Circulation
IS - 5
ER -